Healthcare Provider Details

I. General information

NPI: 1770280711
Provider Name (Legal Business Name): ABIGAIL NICOLE SCHREITER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2023
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 DELAFIELD ST STE 209
WAUKESHA WI
53188-3403
US

IV. Provider business mailing address

1111 DELAFIELD ST STE 209
WAUKESHA WI
53188-3403
US

V. Phone/Fax

Practice location:
  • Phone: 262-542-0444
  • Fax: 262-542-8214
Mailing address:
  • Phone: 262-542-0444
  • Fax: 877-332-3131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number7062-23
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: